Showing papers in "Disaster Medicine and Public Health Preparedness in 2021"

Changes in Body Weight, Physical Activity, and Lifestyle During the Semi-lockdown Period After the Outbreak of COVID-19 in China: An Online Survey.

Abstract: Objectives: The outbreak of novel coronavirus (COVID-19) provided an opportunity to undertake an online survey to study the relationships between body weight changes with changes in physical activity and lifestyle during an unusual event of forced isolation, or quarantine. Methods: We distributed an electronic questionnaire using the popular social application WeChat to adults from any province of China except Hubei Province, the epicenter of the outbreak. The questionnaire asked for demographic information, body weight, physical activity, and lifestyle factors before and during the quarantine. Results: Of 376 questionnaires returned, 339 were valid (90.2%). During the period of semi-lockdown, both females and males with BMI <24 gained weight, males with BMI ≥24 lost weight, and females with BMI ≥24 gained weight. The average steps per day and the average moderate or vigorous-intensity exercise declined significantly for both males and females during the semi-lockdown. Changes in body weight inversely correlated with changes in steps per day and moderate or vigorous-intensity exercise during the quarantine. Conclusions: Normal weight individuals, who are not normally troubled by overweight or obesity, had less awareness of weight gain than people with a BMI ≥ 24. Under the conditions of the semi-lockdown, they tended to gain weight.

Disaster Literacy and Public Health: A Systematic Review and Integration of Definitions and Models.

Abstract: Objective: The aim of this study is to develop an integrated definition and a conceptual model covering the dimensions of disaster literacy Methods: A systematic literature review was conducted to identify the definitions and conceptual frameworks of disaster literacy The content analysis of definitions and conceptual frameworks were conducted to identify the central dimensions of disaster literacy and to develop an integrated model Results: In this study, 8 disaster literacy definitions and 4 conceptual model studies related to disasters were found In line with these studies, a comprehensive definition of disaster literacy was presented In addition, based on content analysis, a 16-matrix integrative conceptual model of the mitigation, preparedness, response and recovery dimensions of disaster literacy, and the access, understanding, appraisal, and application areas of disaster information processing were developed Conclusions: In this study, a comprehensive definition and conceptual framework of disaster literacy were presented in an integrated model By using this model, practices that are special to the phases of a disaster can be identified and supported in society In addition, the model can contribute to empirical studies by providing the basis for the development of tools to measure disaster literacy

Text4Hope: Receiving Daily Supportive Text Messages for 3 Months During the COVID-19 Pandemic Reduces Stress, Anxiety, and Depression.

Abstract: BACKGROUND: This study reports on the changes in stress, anxiety, and depressive symptoms of subscribers after 3 months using Text4Hope, a supportive text messaging program designed to provide support during the pandemic. METHODS: Standardized self-report measures were used to evaluate perceived stress (measured with the Perceived Stress Scale-10 [PSS-10]), anxiety (measured with the General Anxiety Disorder Scale 7 [GAD-7]), and depressive symptoms (measured with the Patient Health Questionnaire [PHQ-9]), at baseline and 3rd month (n = 373). RESULTS: After 3 months of using Text4Hope, subscribers' self-reports revealed significant (p< 0.001) mean score reductions compared with baseline on: the GAD-7 by 22.7%, PHQ-9 by 10.3%, and PSS-10 scores by 5.7%. Reductions in inferred prevalence rates for moderate to high symptoms were also observed, with anxiety demonstrating the largest reduction (15.7%). CONCLUSIONS: Observed Text4Hope-related reductions in psychological distress during COVID-19 indicate that Text4Hope is an effective, convenient, and accessible means of implementing a population-level psychological intervention.

Public-Private-People Partnerships (4P) for Improving the Response to COVID-19 in Iran.

Abstract: The Public-Private-People partnership (4P) is a significant element in disaster response. Coronavirus disease (COVID-19) as a pandemic has been the worst disaster in the last decades in Iran in terms of exposure and magnitude. In order to respond effectively, the Iranian Government needs an extra capacity, which may be provided by the private sector and people. This study aims to collect evidences of 4P pertaining to the COVID-19 response in Iran from February to April 2020. Partnership case studies are classified into 3 categories: (1) Public-private partnerships; (2) public-people partnerships; and (3) private-people partnerships. It was found that the Iranian Government has removed or diminished some of the barriers to cooperation. There was also more cooperation between the people, the private sector, and the public sector than during normal times (vs disasters). People participated in the response procedure through some associations or groups, such as religious and ethnic communities, as well as through non-governmental organizations. It has been shown that 4P is vital in disaster response and, in particular, to epidemics. The government can be more active in partnerships with the private sector and people in emergencies, such as the COVID-19 pandemic. Enhancing social capital, institutionalization, and developing required infrastructures by the government will improve public-private partnerships.

Impact of COVID-19 lockdown on body weight, eating habits and physical activity of Jordanian children and adolescents.

Abstract: OBJECTIVE The lockdown for the COVID-19 pandemic affects lifestyle patterns globally and impacts children and adolescents. This study aims to assess the effect of the lockdown on body weight, eating habits, and physical activity of Jordanian youth (children and adolescents). METHODS A cross-sectional study was conducted on a sample of 477 Jordanian children and adolescents aged 6-17 y. The study tool was a structured validated questionnaire. It comprised 4 parts, including a general description of the study purpose, sociodemographic and anthropometric data, physical activity data, and food intake pattern. Questions were reported before and during lockdown. Changes in outcomes over the 2 study time points were evaluated. RESULTS After the lockdown period, the mean body weight and body mass index for age Z-scores (BAZ) showed a significant increase (P < 0.001) compared with before the lockdown period. More than 50% of the subjects reported that they spent more than 3 h in front of the screen during the lockdown. The percent of subjects who watched TV for more than 3h was increased. Moreover, physical inactivity was increased significantly during the lockdown. All food groups consumption was significantly increased during the lockdown compared to before the lockdown. CONCLUSIONS COVID-19 lockdown period was characterized by an increase in the use of screen-based devices, lower physical activity, uncontrolled food intake, and weight gain.

Use of Incident Command System for Disaster Preparedness: A Model for an Emergency Department COVID-19 Response.

Abstract: The COVID-19 pandemic has placed unprecedented demands on health systems, where hospitals have become overwhelmed with patients amidst limited resources Disaster response and resource allocation during such crises present multiple challenges A breakdown in communication and organization can lead to unnecessary disruptions and adverse events The Federal Emergency Management Agency (FEMA) promotes the use of an incident command system (ICS) model during large-scale disasters, and we hope that an institutional disaster plan and ICS will help to mitigate these lapses In this article, we describe the alignment of an emergency department (ED) specific Forward Command structure with the hospital ICS and address the challenges specific to the ED Key components of this ICS include a hospital-wide incident command or Joint Operations Center (JOC) and an ED Forward Command This type of structure leads to a shared mental model with division of responsibilities that allows institutional adaptations to changing environments and maintenance of specific roles for optimal coordination and communication We present this as a model that can be applied to other hospital EDs around the country to help structure the response to the COVID-19 pandemic while remaining generalizable to other disaster situations

Assessment of Countries' Preparedness and Lockdown Effectiveness in Fighting COVID-19.

Abstract: OBJECTIVES: The aim of this study was to assess the risks in confronting the coronavirus disease 2019 (COVID-19) pandemic and the ongoing lockdown effectiveness in each of Italy, Germany, Spain, France, and the United States using China's lockdown model simulation, and cases forecast until the plateau phase METHODS: Quantitative and qualitative historical data analysis Total Risk Assessment (TRA) evaluation tool was used to assess the pre-pandemic stage risks, pandemic threshold fast responsiveness, and the ongoing performance until plateau The Infected Patient Ratio (IPR) tool was developed to measure the number of patients resulting from 1 infector during the incubation period Both IPR and TRA were used together to forecast inflection points, plateau phases, intensive care units' and ventilators' breakpoints, and the Total Fatality Ratio RESULTS: In Italy, Spain, France, Germany, and the United States, an inflection point is predicted within the first 15 d of April, to arrive at a plateau after another 30 to 80 d Variations in IPR drop are expected due to variations in lockdown timing by each country, the extent of adherence to it, and the number of performed tests in each CONCLUSIONS: Both qualitative (TRA) and quantitative (IPR) tools can be used together for assessing and minimizing the pandemic risks and for more precise forecasting

Efficacy of Serology Testing in Predicting Reinfection in Patients With SARS-CoV-2.

Abstract: In many parts of the United States, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases have reached peak infection rates, prompting administrators to create protocols to resume elective cases As elective procedures and surgeries get scheduled, ambulatory surgery centers (ASCs) must implement some form of widespread testing in order to ensure the safety of both the ASC staff and the patients being seen The US Centers for Disease Control and Prevention (CDC) recently announced the approval of new serological testing for SARS-CoV-2, a test that can indicate the presence of IgM and IgG antibodies in the serum against viral particles However, the possibility for reinfection raises questions about the utility of this new serological test, as the presence of IgG may not correspond to long-term immunity SARS-CoV-2 has been known to form escape mutations, which may correspond to a reduction in immunoglobulin binding capacity Patients who develop more robust immune responses with formation of memory CD8+ T-cells and helper CD4+ T-cells will be the most equipped if exposed to the virus, but, unfortunately, the serology test will not help us in distinguishing those individuals Given the inherent disadvantages of serological testing, antibody testing alone should not be used when deciding patient care and should be combined with polymerase chain reaction testing

Role of Religious Institutions in Disaster Risk Management: A Systematic Review.

Abstract: Objectives: The aim of this systematic review is to analyze the relevant research on religious organizations’ participation in disasters risk management and to understand the ways in which these organizations impact on disaster management. Today, community-based disaster risk management is emphasized as a very effective approach. Religious organizations are one of the most important components of community. They have access to resources that can be critical to help government agencies to manage disasters successfully. Methods: This systematic review was conducted since August 2018 to investigate the role of religious institutions in disasters management and was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Web of Science (WOS), Scopus, Proquest, Embase, and Google scholar were the primary databases used for search of literature. Keywords used in this review were “religious institution,” “disaster management,” and their equivalents were obtained from Mesh, Emtree, or extracted from related articles. The papers from a broad range of disciplines related to keywords were included, and those articles that focus on response to disaster based on religious beliefs’ and religion rather than participation of religious institutions in disaster risk management were excluded. From the 18,071 records identified through database searching in the early stage, 22 articles were selected for this review followed by analysis of the characteristics and content analysis of the included studies to answer the study questions. Results: The findings of this systematic review that emerged from content analysis are summarized in 11 themes: religious institutions’ potential for disaster management, preparedness of religious institutions for disasters, response, recovery, the social capital, partnership with all stakeholders, collaboration and communication between mental health professionals and faith-based organization leaders, unity of information and message, religious institution shelters, dealing with disaster in old and new approaches, and barriers and challenges. Conclusions: Religious institutions have a vital role and great potential in disasters management. They often contribute in response and recovery phases of disasters, although these services are valuable but the great potential of these groups should also be recruited to participate in preparedness and mitigation efforts as part of disasters cycle. Coordination and collaboration of all stakeholders is essential in this way.

Factors Associated With the Work Intention of Hospital Workers' in South Korea During the Early Stages of the COVID-19 Outbreak.

Abstract: Objective: This study aims to explore factors associated with the work intention of hospital workers in the early stages of the coronavirus disease (COVID-19) outbreak in South Korea Methods: An online self-reported survey was conducted in a tertiary hospital Respondents were asked to report their perceived threat and perceived risk of infection, evaluation of hospital response, demographics, and job-related factors Descriptive statistics and multivariate regression analyses were performed Results: A total of 441 employees participated in this study Of respondents, 60% were willing to accept their work during an infectious disease outbreak and 125% were unwilling to accept the work In addition, 8% of respondents reported that they had considered quitting their job, 544% reported that their job was dangerous, and 501% of respondents perceived the severity of COVID-19 as high Perceived threat and effectiveness of hospital response were associated with hospital employees’ intention to work Conclusions: Hospital workers are at the front line of the COVID-19 outbreak This study highlighted hospital workers’ perceived effectiveness of organizational response to the outbreak, and perceived threats were found to be important factors for whether they continued to work or not in the fight against the outbreak

Biosafety for Dental Patients During Dentistry Care After COVID-19: A Review of the Literature.

Abstract: The world is currently changing due to coronavirus disease 2019 (COVID-19), and the field of dentistry is no stranger to this. The care of patients in the dental office involves very strict biosafety protocols, and patients must be aware of the protection barriers implemented to allow satisfactory, safe dental care. The purpose of this study was to synthesize and analyze the management of the current biosafety standards for dental patients since the arrival of the COVID-19 pandemic. A bibliographic search of the main sources of information including MEDLINE (by means of PubMed), Scopus, Science Direct, SCIELO, and Google Scholar was carried out. Articles published without language restriction, systematic reviews, literature reviews, and observational studies were included. We identified the biosafety measures that must be taken before, during, and after dental practice following the arrival of COVID-19. The main measures include telephone triage, temperature taking on arrival at the office, the organization of the waiting room, washing hands before entering the office, knowing the auxiliary radiographic exams of choice and what type of treatment can be performed, albeit with restrictions. In conclusion, dental patients must comply with all the biosafety measures established by international protection standards and implemented by dentists before, during, and after dental practice to reduce the possibility of COVID-19 infection.

Applications of Robotics, AI, and Digital Technologies During COVID-19: A Review.

Abstract: Many countries have enacted a quick response to the unexpected COVID-19 pandemic by utilizing existing technologies. For example, robotics, artificial intelligence, and digital technology have been deployed in hospitals and public areas for maintaining social distancing, reducing person-to-person contact, enabling rapid diagnosis, tracking virus spread, and providing sanitation. In this paper, 163 news articles and scientific reports on COVID-19-related technology adoption were screened, shortlisted, categorized by application scenario, and reviewed for functionality. Technologies related to robots, artificial intelligence, and digital technology were selected from the pool of candidates, yielding a total of 50 applications for review. Each case was analyzed for its engineering characteristics and potential impact on the COVID-19 pandemic. Finally, challenges and future directions regarding the response to this pandemic and future pandemics were summarized and discussed.

Knowledge, Attitude, and Practices (KAPs) of Community Pharmacists Regarding COVID-19: A Cross-Sectional Survey in 2 Provinces of Pakistan.

Abstract: OBJECTIVE The 2019 coronavirus disease (COVID-19) is a global pandemic with no therapy, and pharmacists being a part of the health care system have a vital role in the management of COVID-19. The purpose of this study is to assess the knowledge, attitude, and practices of community pharmacists (CPs) regarding COVID-19. METHOD An online survey was conducted among 393 CPs in 2 provinces of Pakistan during the lockdown period. A validated questionnaire (Cronbach's alpha, 0.745) was used for data collection. All statistical analyses were analyzed by using SPSS, version 21 (IBM Corp, Armonk, NY). RESULTS Among 393 participants, 71.5% (n = 281) had good knowledge, 44% (n = 175) had a positive attitude, and 57.3% (n = 225) had good practices regarding COVID-19. Social media (45.29%, n = 178) were reported as the main source to seek information of COVID-19. Good knowledge, age ≥ 26 years, and a PhD degree level were the substantial determinants (P = 5 years, a PhD degree, good knowledge, and a good attitude has higher odds of having good practices as compared with reference categories (P = < 0.05). CONCLUSION In short, a majority of the CPs had good knowledge but had a poor attitude and practice toward the management of COVID-19. Standard-structured educational and counseling programs for CPs regarding COVID-19 are needed for effective management.

Stigma Associated with COVID-19 Among Health Care Workers in Indonesia.

Abstract: OBJECTIVE: The aim of this study was to assess the stigma associated with coronavirus disease - 2019 (COVID-19) among health care workers (HCWs) in Indonesia during the early phase of the pandemic. METHODS: A cross-sectional study was conducted in 12 hospitals across the country in March, 2020. A logistic regression was employed to assess the association between stigma and explanatory variables. RESULTS: In total, 288 HCWs were surveyed, of which 93.4% had never experienced any outbreaks. Approximately 21.9% of the respondents had stigma associated with COVID-19. HCWs who were doctors, had not participated in trainings related to COVID-19, worked in the capital of the province, worked at private hospitals, or worked at a hospital with COVID-19 triage protocols were likely to have no stigma associated with COVID-19. CONCLUSIONS: The stigma associated with COVID-19 is relatively high among HCWs in the early phase of the COVID-19 pandemic in Indonesia. Adequate dissemination of knowledge and adequate protection are necessary to reduce stigma among HCWs.

Mental Disorders in Firefighters Following Large-Scale Disaster.

Abstract: Firefighting service is known to involve high rates of exposure to potentially traumatic situations, and research on mental health in firefighting populations is of critical importance in understanding the impact of occupational exposure. To date, the literature concerning prevalence of trauma-related mental disorders such as posttraumatic stress disorder (PTSD) has not distinguished between symptomology associated routine duty-related exposure and exposure to large-scale disaster. The present systematic review synthesizes a heterogeneous cross-national literature on large-scale disaster exposure in firefighters and provides support for the hypothesis that the prevalence of PTSD, major depressive disorder, and anxiety disorders are elevated in firefighters compared with rates observed in the general population. In addition, we conducted narrative synthesis concerning several commonly assessed predictive factors for disorder and found that sociodemographic factors appear to bear a weak relationship to mental disorder, while incident-related factors, such as severity and duration of disaster exposure, bear a stronger and more consistent relationship to the development of PTSD and depression in cross-national samples. Future work should expand on these preliminary findings to better understand the impact of disaster exposure in firefighting personnel.

Assessment of Knowledge, Attitudes, and Readiness to Practice Regarding Disaster Medicine and Preparedness Among University Health Students.

Abstract: Objectives: The aim of this study is to assess the knowledge (K), attitude (A), and readiness to practice (rP) levels regarding disaster medicine and preparedness among health profession students at Qatar University. Methods: A survey-based study was carried out to assess medical, pharmacy, and health sciences students’ KArP levels using pretested and validated questionnaire. Student’s t-test, analysis of variance, correlation, and linear regression were used with an alpha level of 0.05. Results: The difference in the mean KArP level between genders was not significant (P > 0.05). Students from the College of Health Sciences had significantly higher KArP levels than those from the College of Pharmacy (101.5 vs 90.0; P = 0.033). Overall, Qatari students had better knowledge, attitude, and readiness to practice scores and total KArP scores than non-Qatari students. Moreover, students who were born in Qatar also had better knowledge, attitude, and readiness to practice scores and total KArP scores than students who were born outside Qatar. Significant direct moderate correlations were found among the 3 KArP parameters (P < 0.001). Knowledge and attitudes were indicated to be significant predictors of readiness to practice (P < 0.001). Conclusions: Students from the health colleges at Qatar University have moderate disaster medicine preparedness

Health System Preparedness for COVID-19 and Its Impacts on Frontline Health-Care Workers in Nepal: A Qualitative Study Among Frontline Health-Care Workers and Policy-Makers.

Abstract: BACKGROUND: Rapidly growing coronavirus disease 2019 (COVID-19) pandemic has brought unprecedented challenges to the health system in Nepal. The main objective of this study was to explore the health system preparedness for COVID-19 and its impacts on frontline health-care workers in Nepal. METHODS: Semi-structured interviews were conducted among 32 health-care workers who were involved in clinical care of COVID-19 patients and four policy-makers who were responsible for COVID-19 control and management at central and provincial level. Interviews were conducted through telephone or Internet-based tools such as Zoom and Skype. All interviews were audio-recorded, transcribed into English, and coded using inductive and deductive approaches. RESULTS: Both health-care workers and policy-makers reported failure to initiate pre-emptive control measures at the early stages of the outbreak as the pivot in pandemic control. Although several measures were rolled out when cases started to appear, the overall health system preparedness was low. The poor governance, and coordination between three tiers of government was compounded by the inadequate personal protective equipment for health-care workers, insufficient isolation beds for patients, and poor engagement of the private sector. Frontline health-care workers experienced various degrees of stigma because of their profession and yet were able to maintain their motivation to continue serving patients. CONCLUSION: Preparedness for COVID-19 was affected by the poor coordination between three tiers of governance. Specifically, the lack of human resources, inadequate logistic chain management and laboratory facilities for testing COVID-19 appeared to have jeopardized the health system preparedness and escalated the pandemic in Nepal. Despite the poor preparedness, and health and safety concerns, health-care workers maintained their motivation. There is an urgent need for an effective coordination mechanism between various tiers of health structure (including private sector) in addition to incentivizing the health-care workers for the current and future pandemics.

Domestic violence and coping strategies among married adults during lockdown due to Coronavirus disease (COVID-19) pandemic in India: a cross-sectional study.

Abstract: Background There has been a reported increase in cases of domestic violence during the coronavirus disease 2019 (COVID-19) pandemic; however, systematic research data are still unavailable. This study was conducted to find out domestic violence prevalence and coping strategies among married adults during lockdown due to COVID-19 in India. Methods A cross-sectional study was conducted among married men and women in the month of April 2020. Data regarding socio-demographic profile, domestic violence, and coping strategies used during lockdown were collected thorough Google Forms. A total of 97.9% of the forms were completely filled by the respondents. A descriptive analysis was done. Results Of 94 study participants, approximately 7.4% (n = 7) had faced domestic violence during lockdown. Of these 7 participants, approximately 85.7% (n = 6) reported increased frequency of domestic violence during lockdown. Approximately half of the victims chose to ignore it (57.1%; n = 4) or used yoga/meditation (42.9%; n = 3) to cope. Conclusions With approximately 7.4% study participants facing domestic violence during lockdown, it is necessary to study its detailed epidemiology in pandemics so that interventions like helpline numbers, screening of patients during tele-consultation, etc., which can be delivered even during lockdown with the help of health-care and frontline workers could be devised to address this problem.

Fear of Contagion: One of the Most Devious Enemies to Fight During the COVID-19 Pandemic.

Abstract: An impressive reduction in emergency department patient attendance was observed during the coronavirus disease (COVID-19) pandemic coupled with an increase in the burden of patients with respiratory failure compared with the same period in 2019. These data are in line with the reduction in the hospital admissions rate for acute coronary syndrome observed during the COVID-19 outbreak, probably due to the patients' fears of being infected during a hospital stay. All these factors may have contributed to the out-of-hospital cardiac arrest (OHCA) occurrence increase observed during the same period. The OHCAs rate increase can recognize 2 great sets of causes: the infection-related and the pandemic-related ones. If the first recognizes different underlying mechanisms that can be dealt with more and more effectively as evidence accumulates, we must remember also the latter: the fear of in-hospital contagion and the willingness not to further burden the health system, which can prevent some citizens from the activation of the emergency medical services (EMS) even in the case of symptoms suspected for time-dependent diseases, resulting in at-home deterioration until the OHCA occurrence. Information campaigns during pandemic must focus also on the importance of EMS early activation in case of real need to prevent COVID-19 from being a disease that kills at home.

Awareness Among Undergraduate Students of Mangalore City Regarding Novel Coronavirus (COVID-19): A Questionnaire Study.

Abstract: Background: COVID-19 outbreak has surfaced as an imminent threat for the public health. Since India is a populous country, it is important for Indians to be aware of the basic modes of prevention that can diminish the spread of the COVID-19 infection. Aim: The present questionnaire study was carried out among the undergraduate students to assess the awareness regarding the spread and control of COVID-19. Methods: The questionnaire was circulated among the undergraduate students as a google form. Results: The study included responses of 868 undergraduate students belonging to two university colleges. Majority of the participants were females (63%, n=547) in the age range of 18-23 years. About 98.3% (853) had awareness regarding COVID-19. About 94.7% (822) were washing their hands after visiting public places, out of which only 90.6% (786) were aware of proper steps to be followed in hand washing. It was concluded that it is required to create awareness among 20.8% (181) of our study participants regarding the importance of hand washing to control COVID-19. Conclusion: Awareness regarding COVID-19 among study participants was good. However, a small part of the study population is required to be educated on proper steps to be followed in hand washing.

Typhoons During the COVID-19 Pandemic in the Philippines: Impact of a Double Crises on Mental Health.

Abstract: The Philippines, a disaster-prone country in Asia, was hit by 22 tropical cyclones during the coronavirus disease (COVID-19) pandemic. Among the 22 tropical cyclones, 1 is recorded as the strongest tropical cyclone that made a landfall in world history. The recurrent typhoons in the Philippines during the pandemic have led to a long-lasting humanitarian crisis as hundreds of thousands of houses and collateral assets have been destroyed due to floods and landslides, leaving thousands of Filipinos homeless. Concurrently, the country has been experiencing a rise in the number of COVID-19 cases due to overcrowding in evacuation centers and lack of social distancing. The simultaneous existence of natural disasters and pandemic has caused devastating and detrimental effects to the mental health of Filipinos. Nonetheless, the Government of the Philippines, together with the World Health Organization and other humanitarian organizations, has been working hand-in-hand in implementing mental health approaches and providing psychological interventions to Filipinos who were greatly affected by the natural disasters and the COVID-19 pandemic.

COVID-19 Vaccine Hesitancy Among Medical Students: The Next COVID-19 Challenge in Wuhan, China.

Abstract: OBJECTIVE: The purpose of this study was to explore the level of coronavirus disease 2019 (COVID-19) vaccine hesitancy among medical students in Wuhan, China, and to identify the factors and barriers associated with their vaccination decision. METHODS: A cross-sectional survey was launched with 612 medical students recruited by convenience sampling from 6 universities. Data collection measures mainly included a demographic questionnaire, COVID-19 vaccine knowledge questionnaire, and the vaccine hesitancy scale. RESULTS: A total of 58.2% of medical students reported vaccine hesitancy. The most common reasons for this were worrying about the side effects of vaccines (44.4%), uncertainty about vaccine safety (40.4%), and underestimating the risk of exposure to COVID-19 (27.9%). The main factors associated with COVID-19 vaccine hesitancy among participants were their knowledge about COVID-19 vaccine, training related to COVID-19 vaccines, family address, and education level (P < 0.05). CONCLUSIONS: The government, health department and universities in China need to work together and actively communicate with vaccine-hesitant students, establish a standardized COVID-19 vaccine course, and provide on-campus vaccination services.

Face Masks for All and All for Face Masks in the COVID-19 Pandemic: Community Level Production to Face the Global Shortage and Shorten the Epidemic - Corrigendum.

Abstract: The current coronavirus disease 2019 (COVID-19) pandemic caused a global shortage of medical masks, leaving most exposed health personnel without appropriate protection.Since the beginning of the outbreak, the World Health Organization WHO) has revised several times the recommendations on general use of facemasks. Until recently, WHO recommended to limit the use of facemasks to symptomatic people and advised against off-standard solutions. Moreover, recommendations differ among and within countries, causing public confusion and individual initiative.There is wide consensus that universal appropriate use of masks may contribute both to contain the epidemic and to reduce the burden on national procurement, if a community production approach is followed. Especially in low-middle income countries, due to the scarce capacity of national industrial production or import, the use of masks produced at community level may become the only viable option. For the purpose ad hoc guidelines will be needed.Current knowledge and experience call for further and updated review of global and national guidelines to provide clear and consistent criteria to ensure the widest availability and appropriate use of facial protection, bearing in mind populations in socio-economic disadvantaged settings.

Historical Disaster Exposure and Household Preparedness Across the United States.

Abstract: Objectives: The study determined whether households in disaster-exposed communities were more likely to be prepared. Methods: Three measures of preparedness were created using the 2013 American Housing Survey: cumulative, adequate, and minimal preparedness. Cumulative and adequate preparedness were created based on the existing literature. Minimal preparedness measured whether households had at present food, water, access to a vehicle, and funds with which to evacuate. Disaster exposure was measured using historical FEMA disaster declarations. The various preparedness measures were regressed onto historical disaster exposure, controlling for sociodemographic factors. Results: Across all measures of preparedness, historical disaster exposure was a statistically significant predictor of preparedness. Vulnerable households included those where children or the disabled were present. African-American headed households emerged as vulnerable only when minimal preparedness was assessed. Conclusions: Prior disaster exposure increased household preparedness regardless of how preparedness was defined. However, assessing minimal preparedness may better reflect the changing disaster landscape where more and more households are asked to evacuate or shelter-in-place by policy-makers.

The comparison of two risk prediction models specific for COVID-19: The Brescia-COVID Respiratory Severity Scale versus the Quick COVID-19 Severity Index.

Abstract: OBJECTIVE: This study compared the prognostic performances of the Brescia-COVID Respiratory Severity Scale (BCRSS) and the Quick COVID-19 Severity Index (qCSI) scores in hospitalized patients diagnosed with COVID-19. METHODS: The data of all adult patients (over 18 years of age) who were admitted into a state hospital with confirmed COVID-19 between May 1, 2020 and October 31, 2020 were retrospectively examined. The area under the receiver operating characteristic (ROC) curve, known as the area under the curve (AUC), was used to assess the BCRSS prediction rule and the qCSI score to assess the discriminatory power in predicting in-hospital mortality and intensive care unit (ICU) admission. RESULTS: There were 341 patients included in this study. The mean age of the patients was 58.2 ± 17.2, of which 165 were men and 176 were women, and 61.3% of patients had at least one comorbidity. The most common comorbidity was hypertension. The predictive power scores of BCRSS and qCSI were found as very good in terms of in-hospital mortality (AUC 0.804 and 0.847, respectively) and likewise in terms of ICU admission (AUC 0.842 and 0.851, respectively). CONCLUSION: Both BCRSS and qCSI scoring systems were found to be successful in predicting in-hospital mortality and ICU admission in our patient population.

A topic analysis of traditional and social media news coverage of the early COVID-19 pandemic and implications for public health communication.

Abstract: OBJECTIVE: To characterize and compare early coverage of coronavirus disease 2019 (COVID-19) in newspapers, television, and social media, and discuss implications for public health communication strategies that are relevant to an initial pandemic response. METHODS: Latent Dirichlet allocation (LDA), an unsupervised topic modeling technique, analysis of 3271 newspaper articles, 40 cable news shows transcripts, 96,000 Twitter posts, and 1000 Reddit posts during March 4-12, 2020, a period chronologically early in the timeframe of the COVID-19 pandemic. RESULTS: Coverage of COVID-19 clustered on topics such as epidemic, politics, and the economy, and these varied across media sources. Topics dominating news were not predominantly health-related, suggesting a limited presence of public health in news coverage in traditional and social media. Examples of misinformation were identified, particularly in social media. CONCLUSIONS: Public health entities should use communication specialists to create engaging informational content to be shared on social media sites. Public health officials should be attuned to their target audience to anticipate and prevent spread of common myths likely to exist within a population. This may help control misinformation in early stages of pandemics.

COVID-19 at War: The Joint Forces Operation in Ukraine.

Abstract: The ongoing pandemic disaster of coronavirus erupted with the first confirmed cases in Wuhan, China, in December 2019, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) novel coronavirus, the disease referred to as coronavirus disease 2019, or COVID-19. The World Health Organization (WHO) confirmed the outbreak and determined it a global pandemic. The current pandemic has infected nearly 300 million people and killed over 3 million. The current COVID-19 pandemic is smashing every public health barrier, guardrail, and safety measure in underdeveloped and the most developed countries alike, with peaks and troughs across time. Greatly impacted are those regions experiencing conflict and war. Morbidity and mortality increase logarithmically for those communities at risk and that lack the ability to promote basic preventative measures. States around the globe struggle to unify responses, make gains on preparedness levels, identify and symptomatically treat positive cases, and labs across the globe frantically rollout various vaccines and effective surveillance and therapeutic mechanisms. The incidence and prevalence of COVID-19 may continue to increase globally as no unified disaster response is manifested and disinformation spreads. During this failure in response, virus variants are erupting at a dizzying pace. Ungoverned spaces where nonstate actors predominate and active war zones may become the next epicenter for COVID-19 fatality rates. As the incidence rates continue to rise, hospitals in North America and Europe exceed surge capacity, and immunity post infection struggles to be adequately described. The global threat in previously high-quality, robust infrastructure health-care systems in the most developed economies are failing the challenge posed by COVID-19; how will less-developed economies and those health-care infrastructures that are destroyed by war and conflict fare until adequate vaccine penetrance in these communities or adequate treatment are established? Ukraine and other states in the Black Sea Region are under threat and are exposed to armed Russian aggression against territorial sovereignty daily. Ukraine, where Russia has been waging war since 2014, faces this specific dual threat: disaster response to violence and a deadly infectious disease. To best serve biosurveillance, aid in pandemic disaster response, and bolster health security in Europe, across the North Atlantic Treaty Alliance (NATO) and Black Sea regions, increased NATO integration, across Ukraine's disaster response structures within the Ministries of Health, Defense, and Interior must be reinforced and expanded to mitigate the COVID-19 disaster.

Clinical Features of Fatalities in Patients With COVID-19.

Abstract: Objectives: The novel coronavirus disease 2019 (COVID-19) pandemic has spread to over 213 countries and territories. We sought to describe the clinical features of fatalities in patients with severe COVID-19. Methods: We conducted an Internet-based retrospective cohort study through retrieving the clinical information of 100 COVID-19 deaths from nonduplicating incidental reports in Chinese provincial and other governmental websites between January 23 and March 10, 2020. Results: Approximately 6 of 10 COVID-19 deaths were males (64.0%). The average age was 70.7 ± 13.5 y, and 84% of patients were elderly (over age 60 y). The mean duration from admission to diagnosis was 2.2 ± 3.8 d (median: 1 d). The mean duration from diagnosis to death was 9.9 ± 7.0 d (median: 9 d). Approximately 3 of 4 cases (76.0%) were complicated by 1 or more chronic diseases, including hypertension (41.0%), diabetes (29.0%) and coronary heart disease (27.0%), respiratory disorders (23.0%), and cerebrovascular disease (12.0%). Fever (46.0%), cough (33.0%), and shortness of breath (9.0%) were the most common first symptoms. Multiple organ failure (67.9%), circulatory failure (20.2%), and respiratory failure (11.9%) are the top 3 direct causes of death. Conclusions: COVID-19 deaths are mainly elderly and patients with chronic diseases especially cardiovascular disorders and diabetes. Multiple organ failure is the most common direct cause of death.

Developing Public Health Emergency Response Leaders in Incident Management: A Scoping Review of Educational Interventions.

Abstract: During emergency responses, public health leaders frequently serve in incident management roles that differ from their routine job functions. Leaders' familiarity with incident management principles and functions can influence response outcomes. Therefore, training and exercises in incident management are often required for public health leaders. To describe existing methods of incident management training and exercises in the literature, we queried 6 English language databases and found 786 relevant articles. Five themes emerged: (1) experiential learning as an established approach to foster engaging and interactive learning environments and optimize training design; (2) technology-aided decision support tools are increasingly common for crisis decision-making; (3) integration of leadership training in the education continuum is needed for developing public health response leaders; (4) equal emphasis on competency and character is needed for developing capable and adaptable leaders; and (5) consistent evaluation methodologies and metrics are needed to assess the effectiveness of educational interventions.These findings offer important strategic and practical considerations for improving the design and delivery of educational interventions to develop public health emergency response leaders. This review and ongoing real-world events could facilitate further exploration of current practices, emerging trends, and challenges for continuous improvements in developing public health emergency response leaders.

COVID-19 Presenting as Lupus Erythematosus-Like Syndrome.

Abstract: The 2019 coronavirus disease (COVID-19) infection had newly emerged with predominant respiratory complications. Other extrapulmonary features had been recently described. Here, we describe a COVID-19 patient presenting with multiorgan involvement mimicking systemic lupus erythematosus. He was successfully treated with glucocorticoids and tocilizumab.